JACQLENE CHRISTINA BRUNO (PA-C) – Physician Assistant, NPI 1487917613
Physician Assistant
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
6,069 PHYSICIAN ASSISTANT in MI
Provider Addresses for JACQLENE CHRISTINA BRUNO (PA-C)
742 N RENAUD RD
GROSSE POINTE WOODS, MI 482361722
Phone: (734) 358-4650
Type: Mailing
6071 W OUTER DR
DETROIT, MI 482352624
Phone: (313) 966-4800
Type: Location
6071 W Outer Dr
Detroit, MI 482352624
Phone: (313) 966-4800
Type: Location
26901 BEAUMONT BLVD STE 3D
SOUTHFIELD, MI 480333849
Phone:
Fax: (947) 522-0307
Type: Mailing
3555 W 13 MILE RD STE N120
ROYAL OAK, MI 480736710
Phone: (855) 863-8761
Fax: (248) 551-2301
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $61.
Total Amount is formed as General ($61) + Research ($0) + Ownership ($0) = $61.
Last reported payment date: 2024-06-15 • Largest payer in this snapshot: Medtronic, Inc. ($61).
Total Amount
$61
General + Research + Ownership
Payments
1
Total payment records
General Amount
$61
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-15
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $61 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2012-11-21
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20121121000367 | I | Physician Assistant | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48236)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MI | |
| Hematology/Oncology, Internal Medicine | MI | |
| P S Y C H I A T R Y | MI | |
| - | MI | |
| Internal Medicine, Cardiovascular Disease (Cardiology) | MI | |
| Interventional Cardiology, Cardiovascular Disease (Cardiology) | MI | |
| - | MI | |
| - | MI | |
| - | MI | |
| - | MI |
Reviews
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